Chinese Medical Sciences Journal ›› 2021, Vol. 36 ›› Issue (1): 27-34.doi: 10.24920/003789

• 论著 • 上一篇    下一篇

135个父母双亲和子女均患癌症的中国家庭发病特征回顾性分析

刘炬,徐志坚(),毕晓峰,孙萍,黄佳琴   

  1. 防癌体检中心,国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院,北京 100021,中国
  • 收稿日期:2020-06-03 接受日期:2020-09-15 出版日期:2021-03-31 发布日期:2021-04-14
  • 通讯作者: 徐志坚 E-mail:xuzj678@aliyun.com

Characteristics of Chinese Families in Which Children and Both Parents Are Diagnosed with Malignant Tumors: A Retrospective Study

Ju Liu,Zhijian Xu(),Xiaofeng Bi,Ping Sun,Jiaqin Huang   

  1. Department of Cancer Prevention, National Cancer Center / National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China
  • Received:2020-06-03 Accepted:2020-09-15 Published:2021-03-31 Online:2021-04-14
  • Contact: Zhijian Xu E-mail:xuzj678@aliyun.com

摘要:

目的分析父母双亲和至少一个子女均患癌症的中国家庭的癌症发病特点,为制定父母均患癌症人员的早期诊断和筛查方案提供参考。

方法 从国家癌症中心的防癌体检中心自2008年1月至2018年2月间体检人员家族史数据库中搜集父亲、母亲及至少一位子女均患癌的家庭。分析患癌成员的癌症病种及所占比例、诊断年龄的分布特点,子女与父亲或母亲所患癌种及癌症所来源生理系统的相似性。将父亲组、母亲组、女儿组和儿子组中不同肿瘤的发病占比与国家癌症中心肿瘤登记办公室(NCCRC)2013年统计的全国数据进行比较。

结果 从33 200名体检人员癌症家族史数据库中共搜集135个父母双亲与子女均患癌症的家庭纳入研究。肺癌在父亲组(40/135,29.6%)和母亲组(38/135,28.1%)患癌中的占比明显高于NCCRC数据肺癌在男性(23.9%)及女性(14.9%)患癌中的占比。乳腺癌在女儿组患癌的占比(35/109,32.1%)明显高于在母亲组(14/135,10.4%)和NCCRC数据乳腺癌在女性患癌中的占比(17.1%)。71对父子中,患同种癌症的占16.9%(12/71),患癌来源于同一系统的占46.5%(33/71)。这两个指标在109对父女中分别是31.2%(n=34)和10.1%(n=11);在71对母子中分别为36.6%(n=26)和8.5%(n=6);在109对母女中分别为31.2%(n=34)和20.2%(n=20)。父子患来源于同一系统的恶性肿瘤的可能性高于父女(X 2=4.299,P<0.05),而母女患同一种恶性肿瘤的可能性高于母子(X 2=4.506,P<0.05)。罹患癌症的诊断年龄均数在儿子组[(59.4±10.9)岁]和女儿组[(52.4±12.7)岁]明显低于父亲组[(65.5±12.2)岁]和母亲组[(65.7±12.5)岁](均P<0.001)。

结论 父母双亲均患癌的人员在进行癌症早诊或筛查时,应进行多种癌症的全面检查,而不应仅检查与父亲或者母亲同样的恶性肿瘤或者来源于同一系统的恶性肿瘤,并且筛检的开始年龄应较针对一般人群建议的开始年龄提前。男性个体需尤其重视消化系统来源恶性肿瘤的筛检,而女性个体应重点筛查女性特有癌症(乳腺癌、卵巢癌、宫颈癌和子宫癌),尤其应重视乳腺癌的筛查。

关键词: 家族史, 早期诊断, 父母, 儿子, 女儿, 恶性肿瘤

Abstract:

Objective To characterize Chinese families in which both parents and at least one child are diagnosed with malignant diseases and provide reference for cancer screening or early detection in people whose both parents are diagnosed with cancer.

Methods Medical records of all clients to the center of cancer screening and prevention of the National Cancer Center/Cancer Hospital between January 2008 and February 2018 were screened to select families in which both parents and at least one child were diagnosed with malignant diseases. The cancer profiles of fathers, mothers, sons and daughters, their age distribution at diagnosis, and similarity of cancers between two generations were analyzed. The proportions of each cancer in males and females of the cohort were compared with corresponding data from the National Cancer Center Registry of China (NCCRC) in 2013.

Results Totally 135 families were identified from records of 33 200 clients. Proportion of lung cancer in fathers (40/135, 29.6%) and in mothers (38/135, 28.1%) were higher than the national data (23.9% in males and 14.9% in females, respectively). The proportion of breast cancer in daughters (35/109, 32.1%) was higher than that of mothers (14/135, 10.4%) and the national data (17.1%). In 71 father-son pairs of cancer, 46.5% (33/71) were of the same systematic disease, and 16.9% (12/71) were of the same cancer. These two indexes were 31.2% (n=34) and 10.1% (n=11), respectively in the 109 father-daughter pairs of cancer, 36.6% (n=26) and 8.5% (n=6) respectively in the 71 mother-son pairs of cancer, and 31.2% (n=34) and 20.2% (n=20) respectively in the 109 mother-daughter pairs of cancer. Sons were more likely to suffer from cancers originated from the same system as father’s cancer than daughters (χ 2=4.299, P<0.05), and daughters were more likely to suffer from the same cancer as their mother’s cancer than sons (χ 2=4.506, P<0.05). The age (mean ± standard deviation) of the daughters (52.4±12.7) and the sons (59.4±10.9) at diagnosis were significantly younger than the fathers (65.5±12.2) and the mothers (65.7 ±12.5) (all P<0.001).

Conclusions For people whose both parents are diagnosed as cancer, screening or early detection examinations should cover a full range of cancers rather than the cancers their father and mother have suffered, or cancers stemmed from the same system as their parent’s cancers. We suggest screening or early detection program for these special population start earlier than that for the general population, with emphasis on cancers derived from digestive system for males and women-specific cancers, i.e., breast cancer, ovarian cancer, cervical cancer and uterine cancer for females.

Key words: family history, parents, daughter, son, early detection, malignant tumor

基金资助: 国家重点研发计划重大慢性非传染性疾病防控研究专项(2017YFC1308700);北京协和医学院学科建设项目(201920200303)

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